D.C. Mun. Regs. tit. 26, r. 26-D204

Current through Register Vol. 71, No. 49, December 6, 2024

Rule 26-D204 - ELIGIBILITY VERIFICATION

204.1

The Authority shall use the information attested to by the individual on the application, documents provided by the individual, and other information known to the Authority to determine the individual's eligibility for an exemption.

204.2

The Authority shall review income documentation using the procedures related to eligibility for advance payments of the premium tax credit, as specified in 45 CFR, Part 155, Subpart D, except that:

(a) The Authority shall accept an individual's attestation on the application regarding eligibility for minimum essential coverage other than through an eligible employer-sponsored plan, instead of following the procedures specified in 45 CFR § 155.320(b);

(b) The Authority shall use federal and local electronic data sources together with other information provided by the applicant and other information in the records of the Authority to verify income information. This information shall be considered reasonably compatible with an applicant's attestation if any difference or discrepancy does not impact the eligibility of the applicant for the exemption or exemptions for which he or she applied; and

(c) If information the Authority obtains is not reasonably compatible with the information on the application, the Authority shall send the individual a notice following the procedure outlined in §230.5. If documentation needed to resolve the inconsistency does not exist or is not reasonably available to the applicant, and the Authority is unable to otherwise resolve the inconsistency, the Authority on a case-by-case basis may accept an applicant's attestation to the information which cannot otherwise be verified along with an explanation of circumstances as to why the applicant does not have the documentation.

D.C. Mun. Regs. tit. 26, r. 26-D204

Final Rulemaking published at 67 DCR 1236 (2/7/2020)